Avantara Lake Norden

Location & what’s nearby

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Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Short-stay rehab — if you are coming here from a hospital

Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.

Therapy staffing: this home’s payroll records show 0.23 therapist hours per resident per day in 2026Q1 — more than 30% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 12% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.

Staffing

How full it usually is: this home is certified for 50 beds and averages 46.8 residents a day — about 94% occupied, or roughly 3 beds typically open. It runs fairly full. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 3.23 hrs/resident/day is below the 3.48-hour benchmark and RN staffing of 0.78 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.14 is below the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 2.91 hrs/resident/day on weekends vs 3.36 on weekdays — 13% thinner on weekends. RN hours go from 0.92 to 0.44 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 33% is below the national median of 45%.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

• Immediate jeopardy · J2026-02-19 · tag F0803 — failed to meet residents' dietary needs — isolated
  Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on South Dakota Department of Health (SD DOH) facility reported incident (FRI), record review, interview, and policy review, the provider failed to ensure a physician orders for a therapeutic pureed (blended food) diet was followed for one of one sampled resident (1) who had a diagnosis of dysphagia (difficulty swallowing) and received a snack from one of one certified nursing assistant (CNA) (D) that was not the right texture and then required life-saving measures through use of the Heimlich maneuver after the food became lodged in his throat. On 2/18/26 at 12:59 p.m., an Immediate Jeopardy was identified for a facility reported incident (FRI) related to the quality of care and treatment that occurred on 2/11/26 at 12:59 a.m. for a resident who was served the wrong diet and required life-saving measures in an attempt to dislodge the food he choked on. The investigation revealed verbal and written education was initiated on 2/11/26 for the staff, and the resident's dietary information was changed to the…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Past Non-Compliance
• Actual harm · G2023-01-19 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolated
  Provide appropriate pressure ulcer care and prevent new ulcers from developing.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, record review, and policy review, the provider failed to put appropriate interventions in place for one of two sampled resident (289) to prevent a pressure ulcer from developing. Findings include: 1. Observation and interview on 1/18/23 at 11:49 a.m. revealed resident 289: *Was sitting in a recliner in his room with his legs elevated and a heel boot on his left foot. *Stated he had a wound on his heel. *Reported displeasure that it had developed since he moved into the nursing home. 2. Observation on 1/18/23 at 3:49 p.m. of registered nurse (RN) F changing the dressing on resident 289's heel revealed: *She described it to the resident as a nickel size compared to a quarter and then stated to this surveyor that it could not be staged (rated based on how deep the wound was) because of the eschar (dead tissue covering the wound). Review of the nursing admission documentation on 11/16/22 in the electronic medical record (EMR) for resident 289 revealed: *A nursing-admission/readmission UDA (user defined assessment) at 11:44 a.m. by RN E noted a skin…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2026-02-19 · tag F0760 — failed to prevent significant medication errors — pattern
  Ensure that residents are free from significant medication errors.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on South Dakota Department of Health (SD DOH) facility-reported (FRI), observation, interview, record review, and policy review, the provider failed to ensure: Ten of forty-six sampled residents (3,4,5,6,7,8,10,11, and 13) had received their hour of sleep (HS) medications and Two of forty -six sampled residents (9 and 12) had recived the morning medicatons per physicians orders by one of of one licensed vocational nurse (LVN) J. *One of one LVN J had folowed physcian orders and applied a pain patch at the correct dosage for one one resident (2). Findings include:1. Review of the providers 9/9/25 SD DOH FRI involving residents (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, and 13) revealed:*On 9/9/25 at 7:30 a.m., a resident reported she had received her medications that morning. *An audit was conducted by registered nurse (RN) F and indicated residents on the main floor and Alzheimer Care unit (ACU) had their medications signed out on their electronic medication administration record (EMAR), indicating that the…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2023-11-16 · tag F0880 — failed to prevent and control infections — pattern
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and policy review the provider failed to ensure necessary infection control practices in one of two shower rooms that included: *Maintenance of a plastic three drawer towel and washcloth storage bin. *An appropriate and sanitary process for the removal of and transport of bowel movement(s) occurring during showering. *Appropriate care and maintenance of a multi-resident use foot soak basin. *Appropriately individualized resident identified personal hygiene products. Findings include: 1. Observation and interview on 11/15/23 at 2:35 p.m. with certified nursing assistant (CNA) E regarding cleaning the shower room revealed: *The shower room was in the south hallway and was used by all residents except for those residents who resided in the memory care unit. *The shower room was a 6 x 6 feet room with no toilet, sink, or hand sanitizer dispenser. *From the doorway at the back right wall was a shower head, with a commode-style shower chair and a floor drain under it. *Approximately 1.5 feet to the left of the shower chair was a three-drawer plastic…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2023-11-16 · tag F0658 — failed to meet professional standards of care — isolated
  Ensure services provided by the nursing facility meet professional standards of quality.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review the provider failed to ensure a Foley catheter change was completed per a physician's order for one of one sampled resident (93). Findings included: 1. Observation and interview on 11/14/23 at 9:05 a.m. with resident 93 revealed: *He was in his room sitting in a recliner watching television. *There was a catheter drainage bag hanging below his waist attached to the recliner and covered with a blue bag. *The urine in the catheter bag was concentrated and dark yellow. *There was sediment in the urine and the catheter tubing. *He stated he was seen by a urologist. *The staff were good about emptying the urine from the drainage bag and completed catheter care every morning and evening. *He could not recall if the nursing staff had changed his Foley catheter since he arrived at the facility a couple of months ago. Review of resident 93's electronic medical record (EMR) revealed: *He was admitted on [DATE]. *He had a Brief Interview for Mental Status (BIMS) score of…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• No harm found · B2025-03-20 · tag F0657 — failed to keep the care plan current — pattern
  Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, record review, and policy review, the provider failed to ensure resident care plans were updated to accurately reflect the residents' abilities to use call lights effectively for five of five observed sampled residents (5, 18, 20, 21, and 23) with impaired cognition who resided in the memory care unit (MCU). Findings include: 1. Observation and interview on 3/18/25 at 9:35 a.m. and again on 3/19/25 at 1:38 p.m. with resident 5 revealed: *Resident 5 sat on the edge of her bed and her call light was attached to the curtain in the center of the room between the two beds on the opposite side of the room from her bed on her roommate's side of the room on both days. -Both call lights were on the same side of the room away from resident 5. -She was unsure if there was a call light. She looked around and stated, It wouldn't do me any good if I can't get to it. -She said she would go to the dining room when she needed something. Review of resident 5's electronic medical record (EMR) revealed: *Her Brief Interview for Mental Status (BIMS) assessment score was…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has plan of correction

Fines & penalties

No federal fines in the current CMS record.

Part of a chain

This home belongs to LEGACY HEALTHCARE — 89 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →

A home rated well below its chain’s average can signal local problems; a chain with a low average across the board is a bigger pattern worth researching. CMS chain data under-reports private-equity and REIT ownership, so treat this as a floor, not the full picture.

Who owns this facility

CMS files one row per role, so the 21 rows in the source record cover these 11 parties — each is shown once here with every role it holds. Nothing is omitted.

7 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.

Follow the money — this home’s finances

Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.

This home reported $428K paid to related parties (affiliated landlords or management companies) in its most recent cost report.

Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.

Cost & finances

Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.

What families pay in SD